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Uzun ME, Şirin H, Bostancı M, Ekici A. Investigation of anxiety, depression, obsessive-compulsive disorder, and quality of life of children of healthcare workers during the COVID-19 pandemic. Arch Pediatr 2023; 30:445-449. [PMID: 37704523 DOI: 10.1016/j.arcped.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 06/05/2023] [Accepted: 07/07/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND This study aimed to evaluate the anxiety, depression, obsessive-compulsive disorder symptoms, and quality of life of children whose parents were healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic period. METHODS The participants completed a sociodemographic questionnaire, the depression inventory for children (CDI), the screening for anxiety disorders in children (SCARED), the Maudsley obsessive compulsive question list (MOCQL), and the pediatric quality of life inventory (PedsQL) using online applications. A total of 153 children and adolescents whose parents were healthcare workers and 356 children and adolescents whose parents were not healthcare workers were included in the study. RESULTS One tenth of all children participating in our study had a high level of depression, and nearly half of them had a high level of anxiety. There was no significant difference in CDI (p = 0.306), SCARED (p = 0.841), and PedsQL (p = 0.863) scale scores between the two groups. The MOCQL scale scores were higher in the group whose parents were not health professionals for cleanliness (p<0.001), slowness (p = 0.001), and total score (p<0.001). CONCLUSION It was found that all participants were affected by anxiety, depression, and quality of life decline; moreover, obsessive-compulsive symptoms were more common in children whose parents were healthcare workers. In this context, our findings could help determine possible mental health problems of children and adolescents whose parents are or are not healthcare workers.
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Affiliation(s)
- Mehmet Erdem Uzun
- Department of Child Psychiatry, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
| | - Hande Şirin
- Department of Child Psychiatry, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Muharrem Bostancı
- Department of Pediatrics, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
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Yimenicioglu S, Kaya TB, Yıldırım E, Arayıcı S, Bildirici Y, Ekici A. The factors affecting neurodevelopmental outcomes in HIE. Acta Neurol Belg 2023; 123:1903-1909. [PMID: 36352199 DOI: 10.1007/s13760-022-02126-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/23/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Hypoxic ischemic encephalopathy (HIE) has different neurological outcomes. AIM We wanted to see if there was any developmental delay in neonates with hypoxia ischemic encephalopathy who were given therapeutic hypothermia. STUDY DESIGN Retrospective cohort study. METHODS The Denver developmental screening test II (DDST-II) was performed to newborns who had been applied to therapeutic hypothermia. RESULTS There were 69 male and 36 female newborns. The mean 1-min and 5-min Apgar scores were 4.72 ± 2.51 and 7.03 ± 2.017, respectively. The mean pH and mean base excess were 6.92 ± 0.1 and -18.05 ± 5.72, respectively. The most common risk factors were meconium staining (17.1%). There were 67 patients with Stage I, 20 with Stage II, and 18 with Stage III. Diffusion restriction was seen in 13 patients. 28 patients had seizures. In aEEG, 12 patients had burst suppression. Three (2.9%) infants died during hospitalization. 19 patients missed follow-up appointments. Thirteen patients had abnormal development according to DDST-II. Seven patients had gross motor function delays and were diagnosed with cerebral palsy. Three had language skill delays, but two of them had speech disorders after two years of age. Two had delayed milestones. Two had delays in fine motor skills but did not have any sequels after two years of age. A significant difference was found between seizures and the severity of Sarnat stage, intubation in the delivery room with developmental delay. Apgar scores were significantly lower in patients with CP. CONCLUSION We should closely follow-up neonates who had low Apgar scores, seizures, a high Sarnat stage, were intubated in the delivery room.
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Affiliation(s)
- Sevgi Yimenicioglu
- Department of Pediatric Neurology, Health Ministry Eskisehir City Hospital, Eskisehir, Turkey.
| | - Tugba Barsan Kaya
- Department of Neonatal Intensive Care Unit, Eskisehir Osmangazi University Hospital, Eskisehir, Turkey
| | - Egemen Yıldırım
- Department of Neonatal Intensive Care Unit, Health Ministry Eskisehir City Hospital, Eskişehir, Turkey
| | - Sema Arayıcı
- Department of Neonatal Intensive Care Unit, Akdeniz University Hospital, Antalya, Turkey
| | - Yaşar Bildirici
- Department of Pediatrics, Health Ministry Eskisehir City Hospital, Eskisehir, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Health Ministry Bursa Yüksek İhtisas Eğitim Araştirma Hastahanesi, Bursa, Turkey
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Ekici M, Ekici A, Kaygusuz S, İnanç F. CT features of pulmonary embolism in patients with COVID-19 pneumonia. Eur Rev Med Pharmacol Sci 2023; 27:4085-4097. [PMID: 37203834 DOI: 10.26355/eurrev_202305_32316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The aim of this study was to describe the Computed Tomography (CT) features of pulmonary embolism in patients hospitalized for acute COVID-19 pneumonia and to evaluate the prognostic significance of these features. PATIENTS AND METHODS This retrospective study included 110 consecutive patients who were hospitalized for acute COVID-19 pneumonia and underwent pulmonary computed tomography angiography (BTPA) on the basis of clinical suspicion. The diagnosis of COVID-19 infection was determined by CT findings typical of COVID-19 pneumonia and/or a positive result of a reverse transcriptase-polymerase chain reaction test. RESULTS Of the 110 patients, 30 (27.3%) had acute pulmonary embolism and 71 (64.5%) had CT features of chronic pulmonary embolism. Of the 14 (12.7%) patients who died despite receiving therapeutic doses of heparin, 13 (92.9%) had CT features of chronic pulmonary embolism and 1 (7.1%) of acute pulmonary embolism. CT features of chronic pulmonary embolism were more common in deceased patients than in surviving patients (92.9% vs. 60.4%, p=0.01, respectively). Low oxygen saturation and high urine microalbumin creatinine ratio at admission in COVID-19 patients are important determinants of mortality after adjusting for sex and age in logistic procedures. CONCLUSIONS CT features of chronic pulmonary embolism are common in COVID-19 patients undergoing Computed Tomography Pulmonary Angiography (CTPA) in the hospital. The coexistence of albuminuria, low oxygen saturation and CT features of chronic pulmonary embolism at admission in COVID-19 patients may herald fatal outcomes.
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Affiliation(s)
- M Ekici
- Departments of Chest Diseases, Departments of Infectious diseases, Faculty of Medicine, Kirikkale University, Yahşihan/Kirikkale, Turkey.
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Civan AB, Ekici A, Havali C, Kiliç N, Bostanci M. Evaluation of the risk factors for recurrence and the development of epilepsy in patients with febrile seizure. Arq Neuropsiquiatr 2022; 80:779-785. [PMID: 36252585 PMCID: PMC9703884 DOI: 10.1055/s-0042-1755202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Background Although febrile seizure (FS) is generally considered benign and self-limiting, there are differences regarding the risk factors, the prognosis, and the development of epilepsy.
Objective To examine the clinical and sociodemographic characteristics of patients diagnosed with FS, and to determine the risks of recurrence and the development of epilepsy.
Methods Between 2015 and 2019, we performed a retrospective evaluation of 300 patients with FS followed for at least 24 months.
Results The first episode of FS was simple in 72.7% of the patients and complex in 27.3%, and it recurred in 40%. Age under 12 months in the first FS, complex FS, and neurodevelopmental delay were found to statistically increase the risk of recurrence (p < 0.05). A total of 7% of the patients developed epilepsy, and this rate was found to be higher in patients with neurodevelopmental delay and long-term use of antiepileptic drugs (p < 0.001). The development of epilepsy was also observed in 77.8% of the patients with abnormal electroencephalogram (EEG). Epilepsy developed more frequently in those with abnormal EEG (p<0.001).
Conclusions Neurodevelopmental delay was an important risk factor for FS recurrence and the development of epilepsy. Abnormality in the EEG is an important risk factor for the development of epilepsy. We found that the long-term prophylactic treatment did not cause decreases in the recurrence of FS nor in the development of epilepsy.
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Affiliation(s)
- Ahmet Burak Civan
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Pediatrics, Bursa, Turkey
| | - Arzu Ekici
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Pediatric Neurology, Bursa, Turkey
| | - Cengiz Havali
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Pediatric Neurology, Bursa, Turkey
| | - Nevin Kiliç
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Pediatrics, Bursa, Turkey
| | - Muharrem Bostanci
- University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Department of Pediatrics, Bursa, Turkey
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Yimenicioğlu S, Ekici A, Türkeli A, Bildirici Y. Antiepileptic Drug Adverse Cutaneous Reaction in Childhood. Journal of Pediatric Epilepsy 2022. [DOI: 10.1055/s-0042-1749344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractAntiepileptic drug (AED) side effects can result in treatment failure, morbidity, and mortality. Adverse cutaneous drug reactions (ACRs) frequently occur within the first 2 to 3 months of drug use. We wanted to discuss antiepileptic ACRs in childhood in this study. This was a study of 37 pediatric patients who were diagnosed with ACR and treated with AED in the last 5 years. Over a 5-year period, 37 (1.8%) of the 2,064 epilepsy patients had ACRs. There were 23 (62%) male patients and 14 (38%) female patients. Patients had a median age of 6 years (interquartile range: [IQR]: 3.5–10). The ACRs occurred in a median of 20 (IQR: 14–30) days. There were 28 (75%) patients receiving monotherapy and 9 (25%) patients receiving polytherapy. Overall, 22 (59.5%) of the 37 patients used aromatic drugs (AD), while 15 (40.5%) used nonaromatic drugs (NAD). Morbilliform eruptions accounted for the majority of ACRs (84%). Valproic acid (54%) was the most frequently used AED that resulted in ACRs. There was no significant difference in terms of eruption time, gender, or age between AD and NAD. Within 1 to 2 months of initiating a new AED, patients should be closely monitored for ACRs. If an ACR develops for one AED, greater caution should be taken when initiating the other AED. Although it is well established that ADs cause more skin reactions, we found that one of the NADs, valproic acid, causes more skin reactions.
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Affiliation(s)
- Sevgi Yimenicioğlu
- Department of Pediatric Neurology, Health Ministry Eskişehir City Hospital, Eskişehir, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Health Ministry Bursa Yüksek İhtisas Eğitim Araştirma Hastanesi, Bursa, Turkey
| | - Ahmet Türkeli
- Department of Pediatric Immunology and Allergy, Health Ministry Kütahya Health Science University, Kütahya, Turkey
| | - Yasar Bildirici
- Department of Pediatrics, Health Ministry Eskisehir City Hospital, Eskisehir, Turkey
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Yimenicioglu S, Ekici A. COVID-19, Symptoms with Pre-Existing and Not Pre-Existing Neurological Disorders in Pediatrics. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1748921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Objective The symptoms of coronavirus disease 2019 (COVID-19) in children with pre-existing neurological disease are unknown. We aimed to find out the difference in the symptoms of children with pre-existing neurological disease and those without.
Methods In this single-center, retrospective, cohort study, 96 pediatric patients who had COVID-19 between March 2020 and April 2021 were enrolled.
Results There were 35 males and 61 females. The median age was 14 years (interquartile range [IQR] 10.25–16). Fever (38.5%), headache (35.4%), and cough (32.3%) were the most common symptoms. In 53.1%, neurological complaints (headache, taste-smell loss, vertigo, febrile seizure, coma, and ataxia), in 40.6%, respiratory symptoms (cough, dyspnea, rhinitis, and pharyngitis), and in 8.3%, gastrointestinal symptoms (gastroenteritis, vomiting, nausea, and abdominal pain) were seen. While 23 (62.2%) patients with fever did not have neurological complaints, 14 (37.8%) had neurological complaints (p = 0.017). Eight (21.6%) patients with fever were hospitalized (p = 0.067). Fever was seen significantly more frequently with pre-existing neurological disease (p < 0.001). Younger children were more likely to have fever (p = 0.008). Headaches and taste–smell loss were seen more frequently in patients with no pre-existing neurological disease (p < 0.001, p = 0.034, respectively). The patients with headaches were older than the ones without headaches (p < 0.001). Patients with headaches and loss of taste and smell were older than those without (p = 0.003).
Conclusion Neurological symptoms differed significantly between those who had pre-existing neurological disease and those who did not. Headaches and taste–smell loss were seen more frequently in patients with no pre-existing neurological disease. Fever was significantly higher in patients who had pre-existing neurological disease.
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Affiliation(s)
- Sevgi Yimenicioglu
- Department of Pediatric Neurology, Health Ministry Eskisehir City Hospital, Eskisehir, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Health Ministry Bursa Yüksek İhtisas Eğitim Arastirma Hastanesi, Bursa, Turkey
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Ekici A, Ekici M, Baçcıoğlu A, Akyüz İnanç F, Aslan H. Pulmonary embolism in patients with dyspnea after COVID-19 infection. Eur Rev Med Pharmacol Sci 2022; 26:3751-3759. [PMID: 35647858 DOI: 10.26355/eurrev_202205_28872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Pulmonary embolism as a potential complication that may occur late in the course of COVID-19 cases. The aim of our study is to evaluate the frequency of pulmonary embolism in patients with new or ongoing dyspnea after a COVID-19 infection. PATIENTS AND METHODS This is a single-center, prospective observational study to evaluate the clinical and radiological outcomes of consecutive patients presenting outpatient clinic diseases to the chest and a new or ongoing dyspnea after a COVID-19 infection. Demographic, clinical and laboratory data were collected. Dyspnea was evaluated according to the New York Heart Association (NYHA) classification. RESULTS Pulmonary embolism was detected in 23.8% (25/105) of patients with new or ongoing dyspnea after a COVID-19 infection. Proportion of pulmonary embolism in patients with NYHA classes I, II, III and IV were respectively 8.7%, 20.0%, 30.0% and 35.3% (p for trend=0.02). Compared to NYHA class I and II patients with dyspnea, those in NYHA classes III and IV showed a higher rate of pulmonary embolism [31.6% vs. 14.6%, OR: 2.7 (1.0 to 7.1), p=0.04, respectively]. In Logistic Procedures, NYHA classes of dyspnea (OR: 4.3, 95% CI: 1.2 to 16.6, p=0.03) (NYHA class III and IV vs. NYHA class I and II) determine the likelihood of pulmonary embolism after COVID-19 infection. CONCLUSIONS Pulmonary embolism is common in patients with new or ongoing shortness of breath after a COVID-19 infection. Pulmonary embolism is more likely to develop in patients with higher NYHA classes.
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Affiliation(s)
- A Ekici
- Department of Chest Diseases, Kirikkale University Faculty of Medicine, Yahşihan, Kirikkale, Turkey.
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Korkmaz MF, Ekici A, Görükmez O. A Novel Heterozygous ANO3 Mutation in a Child Presenting Tremor with Dystonia and Review of the Literature. Journal of Pediatric Neurology 2021. [DOI: 10.1055/s-0041-1740368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractMutations in ANO3 have recently been identified as an autosomal dominant cause of dystonia (dystonia-24). Since then, the phenotypic spectrum has also been extended in children. Here, we reported a case of a 10-year-old Turkish girl child patient with a novel variant (NM_001313726: c.221dupA, p.Tyr74*), who exhibited tremor with mild dystonia. This report expands the phenotype caused by ANO3 variants and reveals an essential clinical aspect for patients and medical staff.
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Affiliation(s)
- Muhammet Furkan Korkmaz
- Department of Pediatrics, University of Health Sciences, Bursa City Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, University of Health Sciences, Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Orhan Görükmez
- Department of Medical Genetics, University of Health Sciences, Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Abstract
Introduction Genetic causes of the intellectual disability Nonsyndromic Autosomal-Recessive Intellectual Disability Syndrome (MRT47, MIM 616193) are mutations in the recently described FMN2 (formin 2 gene). Case report: A boy with intellectual disability had a novel homozygous nonsense mutation (c.2245C > T/p.Gln749*) leading to a premature stop codon in exon 6 of the FMN2 (NM_001305424) gene detected by Clinical Exome Sequencing (CES). Conclusion: Clinical features of a patient with a novel nonsense FMN2 mutation is presented. We urge the change in the OMIM nomenclature from Mental Retardation, Autosomal Recessive 47 (MRT47, MIM 616193) to 'Nonsyndromic Autosomal-Recessive Intellectual Disability Syndrome'.
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Affiliation(s)
- Orhan Gorukmez
- Department of Genetics, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Ozlem Gorukmez
- Department of Genetics, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Pediatric Neurology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Havalı C, Dorum S, Ekici A, Görükmez Ö. Approaches for diagnosis and treatment in neurotransmitter disorders of childhood. Metab Brain Dis 2021; 36:2255-2262. [PMID: 34550503 DOI: 10.1007/s11011-021-00838-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
Neurotransmitter disorders are a group of neurometabolic syndromes caused by disturbances of neurotransmitter metabolism. The primary aim of this retrospective study is to present patients with disturbances of monoamine neurotransmitter metabolism. Cerebrospinal fluid (CSF) neurotransmitter measurements and genetic analysis were performed on five patients. Five patients who had various movement disorders and motor and cognitive disabilities were included. Four patients were diagnosed with sepiapterin reductase (SR) deficiency, and one was diagnosed with aromatic L-amino acid decarboxylase (AADC) deficiency. Different treatment responses appeared in patients with SR and AADC deficiency. The responses to drug treatment ranged from good to weak in our patients. The diagnosis process is challenging in patients with SR and AADC deficiency, which present similar clinical features to other neurological and metabolic diseases. Investigations of neurotransmitters in CSF and analysis of related genes are essential to differentiate disturbances of monoamine neurotransmitter metabolism from other neurometabolic diseases. For patients with monoamine neurotransmitter disorders, drugs that target these disturbances should be combined as necessary to produce the appropriate response.
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Affiliation(s)
- Cengiz Havalı
- Department of Pediatrics, Division of Neurology, Bursa Yuksek İhtisas Training and Research Hospital, 16310, Yıldırım/Bursa, Turkey.
| | - Sevil Dorum
- Department of Pediatrics, Division of Metabolism, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Department of Pediatrics, Division of Neurology, Bursa Yuksek İhtisas Training and Research Hospital, 16310, Yıldırım/Bursa, Turkey
| | - Özlem Görükmez
- Department of Medical Genetics, Bursa Yuksek İhtisas Training and Research Hospital, Bursa, Turkey
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Abstract
One of the causes of congenital adrenal insufficiency, a genetically heterogeneous disorder is a mutation in the CYP11A1 gene, which is responsible for the initiation of steriodogenesis by converting cholesterol to pregnenolone. Case: In a now 3 years and 3 months-old girl, adrenal insufficiency was diagnosed in the neonatal period. Clinical exome sequencing for primary adrenal insufficiency revealed a homozygous p.Thr330Met (c.989C>T) variant in the CYP11A1 (NM_000781) gene. Conclusion: Different types of inheritance patterns have been observed in CYP11A1-related adrenal insufficiency cases. We consider our case is an due to an autosomal recessive inheritance.
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Affiliation(s)
- Ozlem Kara
- Pediatric Endocrinology, University of Health Sciences Bursa, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Orhan Gorukmez
- Genetics, University of Health Sciences Bursa, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Pediatric Neurology, University of Health Sciences Bursa, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Fatih Celik
- Pediatric Surgical, Bursa Uludag University Medical School, Bursa, Turkey
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Çarman KB, Karal Y, Mert GG, Ekici A, Perk P, Arslantaş D, Yarar C, Dinleyici EÇ. Expression of MicroRNA 146a, 155, 181 and 223 in febrile seizure. Turk J Pediatr 2021; 63:594-601. [PMID: 34449141 DOI: 10.24953/turkjped.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND We studied microRNAs (miRNAs) -146a, -155, -181 and -223 expressions and proinflammatory cytokine levels in children with Febrile seizure (FS) and compared to febrile controls. METHODS This prospective multicenter study examined representative populations in eight different cities in Turkey between June 30, 2018 and July 1, 2019. Blood samples were taken from all children at presentation. The real time (RT) polymerase chain reaction (PCR) were used to measure the expressions of microRNAs and tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) levels were studied by enzyme-linked immuno-sorbent assay. RESULTS The study was conducted with 60 children; 30 children with FS and 30 children in the febrile control group. The seizure was classified as simple FS in 73.3 % and half of the children were experiencing their first FS episode. Although the expression levels of miRNAs-146a, -181a and -155 were higher in febrile seizure patients, only miRNAs 146a level was significantly higher in FS patients. Serum TNF-α, IL-1β, IL-6 levels were higher in the FS group than the controls. The results of statistical analysis showed that there were correlations within miRNA expressions in children with FS. No differences were found considering miRNA expression between FS type, number of FS experienced. CONCLUSIONS miRNAs-146a, -181a, -155 and -223 may be involved in FS pathogenesis. Altered miRNA expression levels might be an adaptive response to inflammation. New therapeutic approaches might be developed based on miRNA expressions in children with FS.
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Affiliation(s)
- Kürşat Bora Çarman
- Division of Pediatric Neurology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Yasemin Karal
- Department of Pediatrics, Trakya University Faculty of Medicine, Edirne
| | - Gül Gülen Mert
- Department of Pediatric Neurology, Çukurova University Faculty of Medicine, Adana
| | - Arzu Ekici
- Department of Pediatric Neurology, Yüksek İhtisas Hospital, Bursa
| | - Peren Perk
- Gaziantep Children's Hospital, Gaziantep
| | - Didem Arslantaş
- Departments of Public Health and Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Coskun Yarar
- Division of Pediatric Neurology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Ener Çağrı Dinleyici
- Departments of Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
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Kısa PT, Yildirim GK, Hismi BO, Dorum S, Kusbeci OY, Topak A, Baydan F, Celik FND, Gorukmez O, Gulten ZA, Ekici A, Ozkan S, Yaman A, Arslan N. Patients with cerebrotendinous xanthomatosis diagnosed with diverse multisystem involvement. Metab Brain Dis 2021; 36:1201-1211. [PMID: 33704661 DOI: 10.1007/s11011-021-00714-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 02/02/2023]
Abstract
Cerebrotendinous xanthomatosis (CTX) is a lipid storage disease caused by deficiency of sterol 27-hydroxylase enzyme encoded by CYP27A1 gene. This multicenter, cross-sectional descriptive study aimed to document clinical characteristics of CTX patients of different ages, clinical presentations of early-diagnosed patients, and responses to short-term chenodeoxycholic acid (CDCA) treatment. Seven of 11 CTX patients were diagnosed in childhood. Three patients (27%) had neonatal cholestasis, seven (63%) patients had a history of frequent watery defecation started in infantile period, and eight (72.7%) patients had juvenile cataract. Four patients in the adult age group had pyramidal signs and parkinsonism symptoms. The mean Mignarri score at diagnosis was significantly lower in the pediatric patients (267.8 ± 51.4) than in the adult patients (450.0 ± 64.0, p = 0.001). No significant difference was determined between pediatric patients and adult patients regarding plasma cholestanol concentration at diagnosis (p = 0.482). The frequency of defecation decreased with treatment in six children, who had diarrhea at admission. Compared to pretreatment values, patients' body weight and standardized body mass index significantly increased at the 12th month of treatment. In conclusion, Mignarri scores are lower in the pediatric patients than in adult patients since the most determinative signs of the CTX disease are not apparent yet in the childhood. The disease is frequently overlooked in routine practice as the disease presents itself with different clinical combinations both in adults and in children. CTX is potentially a treatable disease; thereby, enhanced awareness is critically important for early diagnosis particularly in children.
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Affiliation(s)
- Pelin Teke Kısa
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
- Dr. Behçet Uz Children's Research and Training Hospital, Department of Pediatric Metabolism and Nutrition, Izmir University of Health Sciences, Izmir, Turkey
| | - Gonca Kilic Yildirim
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Burcu Ozturk Hismi
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Sevil Dorum
- Bursa Yuksek Ihtisas Training and Research Hospital, Pediatric Metabolic Diseases Clinic, Bursa University of Health Sciences, Bursa, Turkey
| | - Ozge Yilmaz Kusbeci
- Department of Neurology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Ali Topak
- Bursa Yuksek Ihtisas Training and Research Hospital, Medical Genetics Clinic, Bursa University of Health Sciences, Bursa, Turkey
| | - Figen Baydan
- Tepecik Training and Research Hospital, Department of Child Health and Diseases, Division of Pediatric Neurology, Izmir University of Health Sciences, Izmir, Turkey
| | | | - Orhan Gorukmez
- Bursa Yuksek Ihtisas Training and Research Hospital, Medical Genetics Clinic, Bursa University of Health Sciences, Bursa, Turkey
| | - Zumrut Arslan Gulten
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Arzu Ekici
- Bursa Yuksek Ihtisas Training and Research Hospital, Pediatric Neurology Clinic, Bursa University of Health Sciences, Bursa, Turkey
| | - Serhat Ozkan
- Department of Neurology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Aylin Yaman
- Faculty of Medicine, Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | - Nur Arslan
- Department of Pediatrics, Division of Pediatric Metabolism and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
- Izmir Biomedicine and Genome Center (İBG-izmir), 35340, Balcova, Izmir, Turkey.
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Güler Dincer N, Ekici A. Dynamic panel fuzzy time series model and its application to econometric time series. Int J Approx Reason 2021. [DOI: 10.1016/j.ijar.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Havali C, Ekici A, Dorum S, Görükmez Ö, Topak A. Recently defined epileptic encephalopathy related to WWOX gene mutation: six patients and new mutations. Neurol Res 2021; 43:744-750. [PMID: 34034642 DOI: 10.1080/01616412.2021.1932173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: Pathogenic variants of the WWOX gene have been linked to sexual differentiation disorders, spinocerebellar ataxia, and epileptic encephalopathy (EE). We evaluated the clinical and molecular data from six newly diagnosed patients with WWOX-related EE.Methods: Clinical and molecular findings in six patients with EE were investigated, and biallelic pathogenic variants in the WWOX gene were identified. Clinical exome sequencing and Sanger sequencing were performed.Results: Three variations, as well as two novel mutations, in the WWOX gene were detected.Conclusion: Pathogenic WWOX mutations are associated with early-onset EE. Here, we report the case of six children with WWOX-related EE.
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Affiliation(s)
- Cengiz Havali
- Department of Pediatrics, Division of Neurology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Department of Pediatrics, Division of Neurology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Sevil Dorum
- Department of Pediatrics, Division of Pediatric Metabolic Disorders, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Özlem Görükmez
- Department of Medical Genetics, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Ali Topak
- Department of Medical Genetics, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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16
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Carman KB, Karal Y, Gülen Mert G, Ekici A, Perk P, Yarar C, Nuhoğlu Ç, Bozan G, Kılıç Ö, Dinleyici M, Şahin S, Atay E, Tokdemir U, Demir B, Dinleyici EÇ, Study Group DEE. The evaluation of vitamin K status in children with febrile seizure. Balkan Med J 2020; 38:116-120. [PMID: 33045823 PMCID: PMC8909255 DOI: 10.4274/balkanmedj.galenos.2020.2020.5.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Febrile seizure is the most common neurological disorder in childhood. The exact pathophysiology of febrile seizures is unknown. Recent studies showed the role of vitamin K in nonhematological and inflammatory disorders. This study aimed to investigate the serum vitamin K levels in children with febrile seizures. Aims To evaluate vitamin K levels in children with febrile seizures. Study Design Prospective case-control study. Methods This multicenter study examined representative populations in 8 different cities in Turkey between April 1, 2018 and April 1, 2019. Blood samples were taken from all children at presentation. Vitamin K1, vitamin K2, tumor necrosis factor-alpha, interleukin 1 beta, and interleukin 6 levels were determined by enzyme-linked immunosorbent assay. Results A total of 155 children were included in the study—84 children with febrile seizures and 71 children in febrile control group. Serum vitamin K1 and vitamin K2 levels were also higher in children with febrile seizures than in the controls. The results of statistical analysis showed that vitamin K1 and vitamin K2 levels were correlated with tumor necrosis factor-alpha, interleukin 1 beta, and interleukin 6 levels. The median vitamin K1 and vitamin K2 levels of children experiencing their first febrile seizure were higher than those in children with recurrent febrile seizures. Type of febrile seizure has no effect on serum vitamin K1 and vitamin K2 levels. Conclusion In children with febrile seizures, vitamin K levels are higher than those in the control group. These new findings may contribute to elucidating the etiopathogenesis of febrile seizures.
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Affiliation(s)
- Kürşat Bora Carman
- Department of Pediatric Neurology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Yasemin Karal
- Department of Pediatrics, Trakya University School of Medicine, Edirne, Turkey
| | - Gül Gülen Mert
- Department of Pediatric Neurology, Çukurova University School of Medicine, Adana, Turkey
| | - Arzu Ekici
- Clinic of Pediatric Neurology, Yüksek İhtisas Hospital, Bursa, Turkey
| | - Peren Perk
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | - Coşkun Yarar
- Department of Pediatric Neurology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Çağatay Nuhoğlu
- Department of Pediatrics, Haydarpaşa Numune Eduction and Training Hospital, İstanbul, Turkey
| | - Gürkan Bozan
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Ömer Kılıç
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Meltem Dinleyici
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Sabiha Şahin
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Emrah Atay
- Department of Public Health, Eskişehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Uğur Tokdemir
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Baver Demir
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
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17
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Ekici A, Yılmaz İ, Görükmez O, Orcan CG, Dorum S. May PEHO Syndrome be a Clinical Entity Associated with Early Onset Encephalopathies? Ann Indian Acad Neurol 2020; 23:401-403. [PMID: 32606555 PMCID: PMC7313604 DOI: 10.4103/aian.aian_331_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 06/23/2019] [Accepted: 06/23/2019] [Indexed: 11/17/2022] Open
Affiliation(s)
- Arzu Ekici
- Department of Pediatric Neurology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - İlyas Yılmaz
- Department of Pediatrics, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Orhan Görükmez
- Department of Medical Genetics, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Cengiz Gökhan Orcan
- Department of Radiology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Sevil Dorum
- Department of Metabolism, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
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18
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Korkmaz MF, Erdem-Uzun M, Korkmaz M, Ekici A. Adherence to Antiepileptic Drugs and the Health Literacy of Caregivers in Childhood Epilepsy. P R Health Sci J 2020; 39:45-50. [PMID: 32383567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To investigate the relationship between caregivers' health literacy and adherence to treatment in children with epilepsy. METHODS The participants included 226 children and adolescents with epilepsy and their primary caregivers. The demographic and clinical characteristics were abstracted. An antiepileptic drug adherence assessment was done with the validated Morisky Medication Adherence Scale-8 (MMAS-8). According to the scale's scoring system, 0 points indicates high adherence, 1 to 2 points, moderate adherence, and 3 to 8 points, low adherence. A 17-item public health literacy knowledge scale (PHLKS) was used to measure the caregivers' levels of health knowledge. For this scale, higher scores indicate higher levels of health knowledge. A logistic regression model was used to evaluate the effects of demographic characteristics and clinical findings on full drug adherence. RESULTS The overall prevalence of complete drug adherence among patients was 47.3%. The median value of the MMAS-8 score was 1 point (0-8 points). The main reasons for high scores were forgetting to take medication (33.6%) and the difficulties in adhering to treatment (24.3%). The median of the PHLKS score was 13 points (4-17 points). According to the logistic regression results, patients in the 0 to 5 years age group were more likely to have full drug adherence than were those in the 12 to 18 years age group (OR [95% CI]: 2.9 [1.4-6.5]; p = 0.007). As the PHLKS score increased, drug adherence also significantly increased (OR [95% CI]: 0.8 [0.7-0.9]; p = 0.008). CONCLUSION Age and caregivers' health literacy knowledge were found to be significantly associated with adherence. To better define the factors associated with drug adherence in children with epilepsy, additional research (using objective, validated tools) aimed at determining caregivers' health literacy is needed.
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Affiliation(s)
| | - Mehmet Erdem-Uzun
- Department of Child and Adolescent Psychiatry, Yüksek İhtisas Education and Research Hospital, Bursa, Turkey
| | - Merve Korkmaz
- Department of Pediatrics, Dörtçelik Children's Hospital, Bursa, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Yüksek İhtisas Education and Research Hospital, Bursa, Turkey
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19
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Keskin İ, Ekici A, Serdar S. Determination of the growth performance of Mytilus galloprovincialis in nets at Gökçeada Island. The European Zoological Journal 2020. [DOI: 10.1080/24750263.2020.1818856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- İ. Keskin
- Department of Aquaculture, Faculty of Aquatic Sciences, Istanbul University, Istanbul, Turkey
| | - A. Ekici
- Department of Aquaculture, Faculty of Aquatic Sciences, Istanbul University, Istanbul, Turkey
| | - S. Serdar
- Department of Aquaculture, Faculty of Fisheries, Ege University, Izmir, Turkey
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20
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Dorum S, Güney Varal I, Gorukmez O, Dogan P, Ekici A. A novel mutation leading to the lethal form of carnitine palmitoyltransferase type-2 deficiency. J Pediatr Endocrinol Metab 2019; 32:781-783. [PMID: 31199774 DOI: 10.1515/jpem-2019-0038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/07/2019] [Indexed: 11/15/2022]
Abstract
Background The clinical phenotypes of carnitine palmitoyltransferase type-2 deficiency (CPT2D) are classified into lethal neonatal, severe infantile and muscle forms. The rarest form is the lethal neonatal form. Case presentation The patient was hypotonic and bradycardic at admission. Blood urea nitrogen and creatinine were high. He had polycystic kidneys, patent foramen ovale and aortic valve insufficiency. Cranial magnetic resonance imaging (MRI) revealed increased signal intensities in the periventricular white matter. Tandem mass spectrometry (MS) analysis was compatible with CPT2D. We found a homozygous in-frame deletion in the CPT2 gene using next-generation sequencing. Conclusions We identified a novel mutation leading to the lethal form of CPT2D with polycystic kidney, cardiac malformation and cranial MRI findings. Our findings expand the spectrum of causative mutations and clinical findings in CPT2D.
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Affiliation(s)
- Sevil Dorum
- Division of Metabolism, Department of Pediatrics, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Ipek Güney Varal
- Division of Neonatology, Department of Pediatrics, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Orhan Gorukmez
- Department of Genetics, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Pelin Dogan
- Division of Neonatology, Department of Pediatrics, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Division of Pediatric Neurology, Department of Pediatrics, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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21
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HILGERS K, Menendez-Castro C, Ekici A, Cordasic N, Hartner A. SUN-152 POTENTIAL ROLE OF INTERLEUKIN-11 IN A RAT MODEL OF MALIGNANT NEPHROSCLEROSIS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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22
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Kılavuz FG, Ekici A, Onur H, Ekici D, Orcan CG. Intravenous Immunoglobulin: A Good Choice for Acute Cerebellar Ataxia Associated with Varicella. J Pediatr Neurosci 2019; 13:512-513. [PMID: 30937103 PMCID: PMC6413601 DOI: 10.4103/jpn.jpn_79_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Postinfectious cerebellar ataxia is the most common cause of acute ataxia in childhood. The most frequently associated viral agent is varicella. Acute cerebellar ataxia is considered benign, and its symptoms usually diminish within several weeks. We describe a 5-year-old boy who developed gait disorder and garble speech 2 weeks after chicken pox and who was successfully treated with intravenous immunoglobulin.
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Affiliation(s)
- Fatma G Kılavuz
- Department of Pediatrics, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Hatice Onur
- Department of Pediatrics, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Deniz Ekici
- Department of Pediatrics, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Cengiz G Orcan
- Department of Radiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
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23
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Ekici M, Ozgur B, Senturk A, Ekici A, Aydin C, Baykam M. All-Seeing-Access Sheath: A Novel Fluoroscopy-Free Placement
Technique in Retrograde Intrarenal Surgery. J Coll Physicians Surg Pak 2019; 29:263-267. [DOI: 10.29271/jcpsp.2019.03.263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/29/2018] [Indexed: 11/11/2022]
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24
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Carman KB, Calik M, Karal Y, Isikay S, Kocak O, Ozcelik A, Yazar AS, Nuhoglu C, Sag C, Kilic O, Dinleyici M, Lacinel Gurlevik S, Yimenicioglu S, Ekici A, Perk P, Tosun A, Isik I, Yarar C, Arslantas D, Dinleyici EC. Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study). Hum Vaccin Immunother 2018; 15:496-502. [PMID: 30235060 PMCID: PMC6422444 DOI: 10.1080/21645515.2018.1526588] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 08/30/2018] [Accepted: 09/15/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Febrile seizure is the most common childhood neurological disorder, is an important health problem with potential short- and long-term complications, also leading to economic burden and increased parental anxiety about fevers and seizures occurring in their children. There are no routine recommendation to detect etiological causes of FS for neurological perspective, further knowledge about the etiological causes of FS in children will support preventive measures and follow-up strategies. The aim of this study is to evaluate the percentage of respiratory viruses in children with FS. METHODS This prospective multicenter study, entitled "Viral etiological causes of febrile seizures for respiratory pathogens (EFES Study)" examined representative populations in eight different cities in Turkey between March 1, 2016 and April 1, 2017. Nasopharyngeal swabs were taken from all children at presentation. A respiratory multiplex array was performed to detect for influenza A and B; respiratory syncytial virus A and B; human parainfluenza virus 1-2-3 and 4; human coronavirus 229E and OC43; human rhinovirus; human enterovirus; human adenovirus; human bocavirus; human metapneumovirus. RESULTS During the study period, at least one virus was detected in 82.7% (144/174) of children with FS. The most frequently detected virus was adenovirus, followed by influenza A and influenza B. Detection of more than one virus was present in 58.3% of the children with FS, and the most common co-existence was the presence of adenovirus and influenza B. In children younger than 12 months, Coronavirus OC43 was the most common, while influenza A was most frequently observed in children older than 48 months (p < 0.05). Human bocavirus was common in children who experienced complex FS, while respiratory syncytial virus (RSV) A was more common in children who experienced simple FS. Influenza B virus was the most common virus identified in children who were experiencing their first incidence of FS (p < 0.05). CONCLUSIONS This study indicates that respiratory viruses are important in the etiology of FS in children. The results show that antibiotics must be prescribed carefully in children with FS since the majority of cases are related to viral causes. Widespread use of the existing quadrivalent influenza vaccine might be useful for the prevention of FS related to the flu. Further vaccine candidates for potential respiratory pathogens, including RSV, might be helpful for the prevention of FS.
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Affiliation(s)
- Kursat Bora Carman
- Faculty of Medicine, Department of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Mustafa Calik
- Faculty of Medicine, Department of Pediatric Neurology, Harran University, Sanliurfa, Turkey
| | - Yasemin Karal
- Faculty of Medicine, Department of Pediatric Neurology, Trakya University, Edirne, Turkey
| | - Sedat Isikay
- Faculty of Medicine, Department of Pediatric Neurology, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Ozan Kocak
- Department of Pediatric Neurology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Aysima Ozcelik
- Faculty of Medicine, Department of Pediatric Neurology, Gaziantep University, Gaziantep, Turkey
| | - Ahmet Sami Yazar
- Department of Pediatrics, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Cagatay Nuhoglu
- Department of Pediatrics, Haydarapasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Cigdem Sag
- Department of Pediatrics, Haydarapasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Omer Kilic
- Faculty of Medicine, Pediatric Infectious Disease Unit, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Meltem Dinleyici
- Faculty of Medicine, Department of Social Pediatrics, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Sibel Lacinel Gurlevik
- Faculty of Medicine, Department of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Sevgi Yimenicioglu
- Department of Pediatric Neurology, Eskisehir Maternity and Children Hospital, Eskisehir, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Peren Perk
- Faculty of Medicine, Department of Pediatric Neurology, Gaziantep University, Gaziantep, Turkey
| | - Ayse Tosun
- Faculty of Medicine, Department of Pediatric Neurology, Adnan Menderes University, Aydin, Turkey
| | - Ilhan Isik
- Department of Pediatric Neurology, Sanliurfa Children’s Hospital, Sanliurfa, Turkey
| | - Coskun Yarar
- Faculty of Medicine, Department of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Didem Arslantas
- Faculty of Medicine, Department of Public Health, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ener Cagri Dinleyici
- Faculty of Medicine, Department of Pediatrics, Eskisehir Osmangazi University, Eskisehir, Turkey
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25
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Antoniadis S, Häberle L, Rübner M, Büchner K, Blum S, Ekici A, Hartmann A, Hein A, Reis A, Beckmann MW, Renner SP, Fasching PA, Burghaus S. Genetic risk factors for endometriosis, endometrial and ovarian cancer in a German Case-Control Study. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Antoniadis
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - L Häberle
- Universitätsfrauenklinik Erlangen, Biostatistik, Erlangen, Deutschland
| | - M Rübner
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - K Büchner
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - S Blum
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - A Ekici
- Universität Erlangen Institut für Humangenetik, Humangenetik, Erlangen, Deutschland
| | - A Hartmann
- Universität Erlangen, Pathologie, Erlangen, Deutschland
| | - A Hein
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - A Reis
- Universität Erlangen Institut für Humangenetik, Humangenetik, Erlangen, Deutschland
| | - MW Beckmann
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - SP Renner
- Frauenklinik Böblingen, Böblingen, Deutschland
| | - PA Fasching
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - S Burghaus
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
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26
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Ekici MA, Ekici A, Sağıroğlu S, Keyfiala S, Kıvanç BH. Retreatability of root canals obturated using mineral trioxide aggregate-based and two resin-based sealers. Niger J Clin Pract 2018; 21:496-501. [PMID: 29607864 DOI: 10.4103/njcp.njcp_74_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The aim of this study was to compare the retreatment time and the removal efficiency of different root canal sealers using WaveOne Gold reciproc file system by measuring required time. Materials and Methods Forty-five mandibular premolars were prepared and randomly divided into three groups (n = 15). In Groups 1-3, the canals were filled with gutta-percha and mineral trioxide aggregate (MTA) Fillapex, EndoREZ, and AH26, respectively. After 7 days, root canal filling materials (RCFM) were removed with WaveOne Gold reciproc files by measuring time. Teeth were grooved and sectioned longitudinally, then remaining RCFM was evaluated using digital camera. The images were transferred to image analysis software to measure the areas of remaining RCFM. Data were analyzed using one-way analysis of variance and Tukey's test (α = 0.05). Results There was a statistically significant difference between groups according to time required for removing RCFM (P < 0.05). The time required for removing RCFM was significantly shorter in Group 1 and longer in Group 3 than the other groups (P < 0.05). In Group 1, the remaining RCFM was more than other groups at middle third (P < 0.05), but there was no statistically significant difference between groups at coronal and apical thirds (P > 0.05). Conclusions None of the sealers evaluated in this study could completely be removed from the root canals. MTA-based sealer was removed faster than resin-based sealers.
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Affiliation(s)
- M A Ekici
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - A Ekici
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - S Sağıroğlu
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - S Keyfiala
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - B Helvacıoğlu Kıvanç
- Department of Endodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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27
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Küçükçongar Yavaş A, Orhaner B, Genç P, Kılıç N, Erdoğan H, Özdemir Ö, Ekici A. Secondary Hemophagocytic Lymphohistiocytosis in an Infant with Wolman Disease. Turk J Haematol 2017; 34:264-265. [PMID: 27094156 PMCID: PMC5544048 DOI: 10.4274/tjh.2015.0454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Furtmair R, Kuehn C, König C, Ekici A, Klinghammer L, Achenbach S, Reis A, Tauchi M, Dietel B. Phenotype of vulnerable atherosclerotic plaques shows strong association with single nucleotide polymorphism alleles of common risk variants for coronary artery disease. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare lymphoproliferative disorder. HLH may occur as a complication of Epstein-Barr virus (EBV), particularly in patients with immunodeficiencies. Herein, we describe a 16-year-old girl with neurological complications associated EBV-induced HLH. Her cerebral magnetic resonance imaging (MRI) showed contrast-enhanced axial T1-weighted images with enhancement of meningeal surface in the right hemisphere that was consistent with right hemi-meningitis. Hydrocephalus, dilated subdural spaces, delayed myelination, edema, diffuse parenchymal atrophy, calcifications, diffuse/patchy white matter abnormalities have all been previously described with HLH. To the best of our knowledge, this is the first case of hemi-meningitis associated with HLH. We suggest that clinicians should consider HLH with vascular disorders when they determine unilateral meningitis on a brain MRI.
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Affiliation(s)
- Ozan Kocak
- Department of Pediatric Neurology, Eskisehir Osmangazi University Hospital, Eskisehir, Turkey
| | - Coskun Yarar
- Department of Pediatric Neurology, Eskisehir Osmangazi University Hospital, Eskisehir, Turkey
| | - Sevgi Yimenicioğlu
- Department of Pediatric Neurology, Eskişehir State Hospital, Eskisehir, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Bursa Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
| | - Özcan Bör
- Department of Pediatric Hematology, Eskisehir Osmangazi University Hospital, Eskisehir, Turkey
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Pasutto F, Mauri L, Popp B, Sticht H, Ekici A, Piozzi E, Bonfante A, Penco S, Schlötzer-Schrehardt U, Reis A. Whole exome sequencing reveals a novel de novo FOXC1 mutation in a patient with unrecognized Axenfeld–Rieger syndrome and glaucoma. Gene 2015; 568:76-80. [DOI: 10.1016/j.gene.2015.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/17/2015] [Accepted: 05/07/2015] [Indexed: 02/03/2023]
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Yimenicioğlu S, Yakut A, Ekici A, Bora Carman K, Cagrı Dinleyici E. Mycoplasma pneumoniae infection with neurologic complications. Iran J Pediatr 2014; 24:647-51. [PMID: 25793076 PMCID: PMC4359422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 11/03/2013] [Indexed: 10/29/2022]
Abstract
BACKGROUND Extrapulmonary complications of Mycoplasma pneumoniae (M. pneumoniae) infection include encephalitis, optic neuritis, acute psychosis, stroke, cranial nerve palsies, aseptic meningitis and also it may be implicated in immune mediated neurological diseases such as acute demyelinating encephalomyelitis, Guillain-Barre syndrome and transverse myelitis. CASE PRESENTATION We present five cases with acute neurological diseases after M. pneumoniae infection. The clinical presentations were characterized by encephalitis in 2 patients, Gullain-Barre syndrome in 2 patients, transverse myelitis in 1 patient. M. pneumoniae infection was detected in serum by serological method. Only two patients had respiratory symptoms preceding M. pneumoniae infection. Brain MRI revealed hyperintensities on corpus striatum and mesencephalon in one patient with encephalitis, the other had front parietal coalescent periventricular white matter lesions on T2 images. The patient with transverse myelitis had cervical, dorsal and lumbar scattered hyperintense lesions on T2 images. Two patients were treated with high dose steroid, the other two patients received treatment with intravenous immune globuline. CONCLUSION M. pneumoniae may reveal different neurologic complications with different radiologic findings.
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Affiliation(s)
- Sevgi Yimenicioğlu
- Department of Pediatric Neurology,Corresponding Author: Address: Eskısehir Osmangazi University Pediatric Neurology department Eskisehir, Turkey
| | | | | | | | - Ener Cagrı Dinleyici
- Department of Pediatric Infection, Osmangazi University Medicine Faculty, Eskisehir, Turkey
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Moosmann J, Ekici A, Cesnjevar R, Dittrich S, Uebe S, Toka O. X-chromosomal copy number variants in patients with coarctation of the aorta. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1394045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ekici A, Yakut A, Yimenicioglu S, Bora Carman K, Saylısoy S. Clinical and Neuroimaging Findings of Sydenham's Chorea. Iran J Pediatr 2014; 24:300-6. [PMID: 25562024 PMCID: PMC4276585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 04/14/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Sydenham's chorea (SC) is thought to be an autoimmune disorder. MRI is generally used to exclude other causes of chorea. There are no typically defined MRI features of SC. In this study we aimed to determine clinical and neuroimaging findings of SC. METHODS In this study 17 patients with acute SC were retrospectively evaluated. Sydenham's chorea was diagnosed according to the 1992 revision of the Jones criteria. The other causes of chorea were excluded. Cranial MRI was performed in all patients during the acute phase of SC. Walking, speech and swallowing disorders, muscle weakness, behavioral disorders, treatment, symptom recovery time and recurrence were evaluated. Findings : The patients' mean age was 11.2 years. Behavioral changes, muscle weakness and dysphagia occurred in 70%, 64% and 23% of the patients, respectively. Nonspecific signal hyperintensities were observed in the white matter, brain stem and caudate nucleus in 47% of patients. Two patients who had chorea paralytica were treated successfully with a high dose of intravenous methylprednisolone. CONCLUSION Nonspecific hyperintense white matter abnormalities may be due to the inflammatory process associated with a longer duration of clinical signs. To explain the MRI findings and the pathogenesis of SC, comprehensive studies are needed.
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Affiliation(s)
- Arzu Ekici
- Department of Pediatric Neurology ,Corresponding Author: Address: Akarbaşı Mah. Şehit Zeynel Toköz Sok. Önçağ Park Sitesi C Blok Daire:6 ESKİSEHİR / TURKEY
| | | | | | | | - Suzan Saylısoy
- Department of Radiology, Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
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Ekici A, Yakut A, Bör Ö, Yimenicioğlu S, Çarman KB, Saylısoy S. Ptosis during hematologic malignancy in children. Pediatr Int 2014; 56:264-6. [PMID: 24730629 DOI: 10.1111/ped.12238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 07/25/2013] [Accepted: 10/09/2013] [Indexed: 12/01/2022]
Abstract
Neurological symptoms such as ptosis may develop due to either chemotherapeutic agents or involvement of the central nervous system (CNS) during hematologic malignancy. It is difficult to make this distinction according to clinical symptoms and magnetic resonance imaging findings. If the neurologic symptoms are increased, it is a warning of CNS involvement. Herein are described the clinical and neuroimaging features of three patients with hematologic malignancy who presented with ptosis.
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Affiliation(s)
- Arzu Ekici
- Department of Pediatric Neurology, Osmangazi University Medicine Faculty, Eskisehir, Turkey
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Kocak O, Yarar C, Yakut A, Ekici A, Yimenicioglu S, Saylisoy S. Akathisia in association with herpes simplex encephalitis relapse and opercular syndrome in children. Brain Dev 2014; 36:167-70. [PMID: 23518044 DOI: 10.1016/j.braindev.2013.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 02/24/2013] [Accepted: 02/25/2013] [Indexed: 11/20/2022]
Abstract
We report a 2-year-old boy with herpes simplex virus type 1 encephalitis (HSE) and opercular syndrome who presented with clinical relapse characterized by chorea-like involuntary movements that suggest akathisia. The patient initially presented with multiple focal seizures that cause epilepsia partialis continua, polymerase chain reaction (PCR) for herpes simplex virus type 1 was positive. He developed hypersalivation, speech and swallowing difficulties within 30days. Based on these findings the patient was diagnosed as having opercular syndrome due to HSE. He developed akathisia on 44th day of admission as a relapse and he was successfully treated with propranolol. Opercular syndrome might be seen HSE in children and it may cause neurological suquela. Akathisia might be seen after encephalitic process as a symptom of relapse, however diagnosis of akathisia is difficult in young children. It should be noted that because propranolol effective for these involuntary movements. It can be add additional choice of treatment in these patients.
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Affiliation(s)
- Ozan Kocak
- Department of Pediatric Neurology, Osmangazi University Medicine Faculty, Eskisehir, Turkey.
| | - Coskun Yarar
- Department of Pediatric Neurology, Osmangazi University Medicine Faculty, Eskisehir, Turkey.
| | - Ayten Yakut
- Department of Pediatric Neurology, Osmangazi University Medicine Faculty, Eskisehir, Turkey.
| | - Arzu Ekici
- Department of Pediatric Neurology, Osmangazi University Medicine Faculty, Eskisehir, Turkey.
| | - Sevgi Yimenicioglu
- Department of Pediatric Neurology, Osmangazi University Medicine Faculty, Eskisehir, Turkey.
| | - Suzan Saylisoy
- Department of Radiology, Osmangazi University Medicine Faculty, Eskisehir, Turkey.
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Carman KB, Yimenicioglu S, Ekici A, Yakut A, Dinleyici EC. Co-existence of acute transverse myelitis and Guillain-Barré syndrome associated with Bartonella henselae infection. Paediatr Int Child Health 2013; 33:190-2. [PMID: 23930734 DOI: 10.1179/2046905512y.0000000044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Cat scratch disease (CSD) is a benign, self-limiting condition associated with Bartonella henselae. Neurological manifestations are uncommon. Acute transverse myelitis and Guillain-Barré syndrome have been reported rarely with CSD. This report describes a 12-year-old boy with acute transverse myelitis and Guillain-Barré syndrome associated with CSD.
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Carman KB, Ekici A, Yimenicioglu S, Arslantas D, Yakut A. Breath holding spells: point prevalence and associated factors among Turkish children. Pediatr Int 2013; 55:328-31. [PMID: 23782365 DOI: 10.1111/ped.12090] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 11/04/2012] [Accepted: 02/01/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Breath holding spells (BHS) are known as paroxysmal non-epileptic disorder. There are two subtypes of BHS: cyanotic and the pallid. BHS have been reported to occur in 0.1-4.6% of children in Western countries. Although it is easy to diagnose in its typical form, the data on prevalence of BHS are insufficient in developing countries. METHODS This study was performed in Turkey's Eskisehir province. A total of 1000 randomly selected 0-6-year-old children were invited to family health centers. A specific questionnaire was given to parents. Children who had a history BHS were referred to the hospital to for investigation of medical history and neurological examinations. RESULTS A total of 933 children participated and were included in analysis. Thirty-four children (3.6%) had had BHS. Children's birthweight, parent consanguinity and mothers' education status significantly affected the frequency of BHS. Increase in birth sequence decreases the risk of BHS 0.65-fold. Fathers' education status also affected the prevalence of BHS, with the risk of BHS being 0.39-fold less if the father had completed high school or some higher education. And, as the age of the fathers increased, the risk that their children would have BHS was 1.14-fold higher. CONCLUSIONS Although the calculated prevalence rate was compatible with previous studies, positive family history for BHS, birth sequence, parents' education status and fathers' age were identified as risk factors associated with BHS.
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Affiliation(s)
- Kursat Bora Carman
- Department of Pediatric Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey.
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Yimenicioğlu S, Yakut A, Karaer K, Zenker M, Ekici A, Carman KB. A new nonsense mutation in the NF1 gene with neurofibromatosis-Noonan syndrome phenotype. Childs Nerv Syst 2012; 28:2181-3. [PMID: 22965773 DOI: 10.1007/s00381-012-1905-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 08/24/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE Neurofibromatosis-Noonan syndrome is a rare autosomal dominant disorder which combines neurofibromatosis type 1 (NF1) features with Noonan syndrome. NF1 gene mutations are reported in the majority of these patients. METHOD Sequence analysis of the established genes for Noonan syndrome revealed no mutation; a heterozygous NF1 point mutation c.7549C>T in exon 51, creating a premature stop codon (p.R2517X), had been demonstrated. RESULT Neurofibromatosis-Noonan syndrome recently has been considered a subtype of NF1 and caused by different NF1 mutations. CONCLUSION We report the case of a 14-year-old boy with neurofibromatosis type 1 with Noonan-like features, who complained of headache with triventricular hydrocephaly and a heterozygous NF1 point mutation c.7549C>T in exon 51.
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Affiliation(s)
- Sevgi Yimenicioğlu
- Department of Pediatric Neurology, Osmangazi University Medical Faculty, Eskisehir, Turkey.
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Ekici A, Yakut A, Kural N, Bör Ö, Yimenicioğlu S, Çarman KB. Nonconvulsive status epilepticus due to drug induced neurotoxicity in chronically ill children. Brain Dev 2012; 34:824-8. [PMID: 22445289 DOI: 10.1016/j.braindev.2012.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 02/08/2012] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
Abstract
Nonconvulsive status epilepticus (NCSE) is a specific form of status epilepticus and is defined as epileptic activity on an EEG without seizures and as an alteration in mental status lasting more than 30 min. NCSE may be caused by drugs, cerebrovascular events, metabolic disorders or toxins. Herein, we present four cases of patients with drug-induced NCSE who were chronically ill due to renal failure or childhood leukemia. NCSE should be suspected in patients with an altered mental status without clinical seizures who are being treated with multiple drugs.
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Affiliation(s)
- Arzu Ekici
- Department of Pediatric Neurology, Osmangazi University Medicine Faculty, Eskisehir, Turkey.
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Abstract
Subacute sclerosing panencephalitis (SSPE) is a progressive neurodegenerative disorder. Ocular involvement in SSPE has been well known and might be seen in 42 to 50% of the patients. Visual findings are generally seen at stage III with neurological abnormalities. Ophthalmologic involvement might be preceding typical SSPE symptoms.
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Affiliation(s)
- Sevgi Yimenicioglu
- Pediatric Neurology Department, Eskisehir Osmangazi University, Medical Faculty, Eskisehir, Turkey.
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Abstract
OBJECTIVE Insulin resistance (IR) and disorders of glucose metabolism (DGM) are risk factors for cardiovascular diseases. There are different reasons for development of DGM in patients with obstructive sleep apnoea syndrome (OSAS) and this association is controversial. We investigated the frequency of DGM and IR in patients with OSAS and determining factors for these disorders. METHOD One hundred and twelve untreated patients with OSAS and 19 non-apnoeic snoring subjects upon polysomnography were included in this study. Oral glucose tolerance test (OGTT) was performed in all subjects who had fasting blood glucose < 125 mg/dl. IR method was analysed using homeostasis assessment model (HOMA-IR). Diabetes mellitus (DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were defined according to values of OGTT. DGM was defined as having one of the diagnoses of DM, IGT or IFG. Subjective sleepiness of all subjects was assessed with Epworth Sleepiness Scale (ESS). Excessive daytime sleepiness (EDS) was described as ESS score ≥ 10. RESULTS Fasting glucose and the rate of DGM in patients with OSAS were higher than in non-apnoeic snoring subjects. DGM were shown in % 15.7 of non-apnoeic snoring subjects, 29.6% of mild sleep apnoea, 50% of moderate sleep apnoea and 61.8% of severe sleep apnoea. The rate of DGM in patients with moderate and severe OSAS was higher than in non-apnoeic snoring subjects and in patients with severe OSAS higher than in patients with mild OSAS. DGM are associated with body mass index (BMI), severity of OSAS, arousal index and EDS. In addition, IR is associated with apnoea hypopnoea index, BMI, arousal index and ESS score. CONCLUSION Obstructive sleep apnoea syndrome is associated with high frequency of DGM. In addition, the progression of disease from simple snoring and mild OSAS to severe OSAS increases the rate of DGM. Thus, DGM especially in patients with severe OSAS should be examined in regular periods.
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Affiliation(s)
- E Bulcun
- Department of Chest Disease, School of Medicine, Kirikkale University, Kirikkale, Turkey.
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Ekici MA, Kumandas S, Per H, Ekici A, Tucer B, Gumus H, Canoz O, Kurtsoy A. Surgical timing of the subependymal giant cell astrocytoma (SEGA) with the patients of tuberous sclerosis complex. Turk Neurosurg 2011; 21:315-24. [PMID: 21845566 DOI: 10.5137/1019-5149.jtn.4169-11.0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM Tuberous sclerosis complex has shown a wide variety of clinical, pathologic and radiologic manifestations. Many tumor types are found in tuberous sclerosis, which includes subependimal giant cell astrositoma. The aim of this study is to focus on surgical timing of the tumor. MATERIAL AND METHODS This study included 37 children with tuberous sclerosis presenting to Erciyes Univercity Medical School, whose hospital record were retrospectively evaluated between 1995 and 2010. Of the 5 patients had diagnosed with the subependymal giant cell astrocytoma and three patients were opereted on. RESULTS In the 27 of the patients had subependimal nodules (73%), cortical tubers were in the 19 patients (51,4%), giant cell astrositoma (SEGA) were in the 5 patients (13,5%). Mental retardation in different level was detected in the 18 patients (48.6%). The other clinical findings of the patients were angiomyolipomas (37.8%), hypomelanotic macules (91.9%), Convulsion (54.1%), adenoma sebaceum (32.4%) , West syndrome (16.22%), shagreeen patch (16.2%), intracardiac tumor (37.8%), subungual fibroma (2.7%), fibroadenom in the neck (2.7%). CONCLUSION A multidisciplinary approach is essential for an early, accurate diagnosis and proper management of affected individuals. The early surgical menagement for subependimal giant cell astrocytoma are recommended, and also periodic monitoring even for asymptomatic patients with subependymal nodules.
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Affiliation(s)
- Mehmet Ali Ekici
- Bozok University, Faculty of Medicine, Department of Neurosurgery, Yozgat, Turkey.
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Torun YA, Patıroglu T, Ozdemir MA, Ozkul Y, Ekici A, Karakukcu M. Inherited Prothrombotic Risk Factors in Turkish Children With Acute Lymphoblastic Leukemia. Clin Appl Thromb Hemost 2011; 18:218-21. [DOI: 10.1177/1076029611412366] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Our study was designed to prospectively evaluate the role of the methylenetetrahydrofolate reductase (MTHFR) TT677 genotype, the prothrombin (PT) 620210A mutation, the factor V G1691A mutation in leukemic Turkish children treated according to modified BFM 95 study protocols with respect to the onset at thromboembolic events. Eighty-two consecutive leukemic children investigated had are established inherited prothrombotic risk factor: 29 children showed the MTHFR genotype (heterozygous, n = 22; homozygous, n = 7); 3 showed the heterozygous PT G20210A variant; 16 were carriers of the factor V mutation (heterozygous). In addition, combined prothrombotic defects were found in a further 11 patients the MTHFR mutation was combined with the F V mutation (n = 7), the PT G20210A variant (n = 2). In 7 (8.5%) of these 82 patients, venous thromboembolism occurred. In conclusion, the presence of inherited thrombophilia with Turkish children treated acute lymphoblastic leukemia may be useful for designing targeted primary prevention strategies.
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Affiliation(s)
- Yasem’n Altuner Torun
- Department of Pediatric Hematology, State Educational and Research Hospital of the Government, Kayseri, Turkey
| | - Turkan Patıroglu
- Department of Pediatric Hematology, Erciyes University, Kayseri, Turkey
| | | | - Yusuf Ozkul
- Department of Genetics, Erciyes University, Kayseri, Turkey
| | - Arzu Ekici
- Department of Pediatric Neurology, Gazi Osmanpaşa University, Eskişehir, Turkey
| | - Musa Karakukcu
- Department of Pediatric Hematology, Erciyes University, Kayseri, Turkey
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Ekici MA, Ekici A, Per H, Tucer B, Kurtsoy A. Foreign body granuloma mimicking upper cervical spinal mass after dural repair with Tachocomb [correction of Tachocomp]: a case report. Pediatr Neurosurg 2010; 46:133-7. [PMID: 20664302 DOI: 10.1159/000319397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 02/02/2010] [Indexed: 11/19/2022]
Abstract
The common indications of dura mater repair are injuries caused by trauma, neoplasms, surgical complications and congenital spinal dysraphism such as meningomyelocele or encephalocele. Dural grafting is done to recreate the dural barrier and avoid the possible postoperative complications. Autografts derived from periosteum, fascia, muscle and fat. The disadvantages of autografts are their small size and esthetic complaints. To overcome the disadvantages synthetic materials might be used in duroplasty. Here we present a 3-year-old girl who developed muscle weakness in the upper and lower extremities caused by foreign body granuloma mimicking malignancy in the cervical spinal cord after dural repair done via Tachocomb.
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Affiliation(s)
- Mehmet Ali Ekici
- Department of Neurosurgery, Training and Research Hospital, Kayseri, Turkey. mehmetali.ekici @ gmail.com
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Goecke TW, Ekici A, Strick R, Niesler B, Beckmann MW, Fasching PA. Assoziation von Single Nucleotid Polymorphismen (SNP) der Untereinheiten des Serotoninrezeptor-HTR3 – bei Übelkeit und Erbrechen in der Schwangerschaft. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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